Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Anyone told they don't weigh enough by insurance? Appeals, weight gain and more.



Recommended Posts

I was told i did not weigh enough...but i had all the co morbid conditions...i was denied but not for my weight so i did what was missing and appeal and was approved...

Share this post


Link to post
Share on other sites

@ a week!!..my chemical blood work was missing so i had to get it done and resubmitted it..

Edited by Pepper123

Share this post


Link to post
Share on other sites

I was denied by my insurance because they don't cover it. I tried to have the surgery done locally and they told me I wasn't heavy enough, gain 30 more lbs then try again (this was me paying cash and they still said no) I went self pay, spent $4k and had it done in Mexico. I scheduled one week and was in Mexico the next. I'm inpatient and didn't want to wait. Arrived Tuesday, Surgery Wednesday, home on Friday, back to work on Monday. I'd do it all again if I had to.

If you have 4k on a credit card, go that route and get it over it. There is a link on this forum for a place that does it for $3200.00.

Share this post


Link to post
Share on other sites

@@pinkbunies Great turnaround time! May I ask who was your surgeon?

& Congratulations!

Share this post


Link to post
Share on other sites

tbh I'll have to look at the paper work again as I don't remember the surgeons name. The one thing I hated hearing was... your not big enough, this is for people who need it. It made my blood boil and made me more determined.

Sometimes, no matter how hard you try you just can't lose the weight. One day the ignorant insurance companies are going to realize that they will benefit more by having this surgery done vs. letting the person continue to have health problems.

Share this post


Link to post
Share on other sites

Usually an jnsurance company looks at revisions differently than straight new surgery.

Have you asked for their medical criteria in writing? I would. Or Google bcbs name of your state and gastric sleeve it should have the revision guidelines in it.

I have cigna and they have it couple pages after new surgery

Remember bcbs is different by state so make sure you get that state name In there

https://cignaforhcp.cigna.com/public/content/pdf/coveragePolicies/medical/mm_0051_coveragepositioncriteria_bariatric_surgery.pdf

Share this post


Link to post
Share on other sites

How many many pounds were you..I had bsnd removed and now im getting the sleeve. Dr wanted to wait 2 months for healing from band removal. Same thing with me i was t l d to gain about 10 pounds as i am 52 180 pounds...i did gain those 10 pounds in 2 months..just ate eveything and had lots of milkshakes lol...now im approved :) and going in for sleeve mid February.. Cant wait..just finished all my pre op test done with everything just waiting for my day.

Share this post


Link to post
Share on other sites

Im not patient..if they would od declined it would of went to Mexico as my friend did for 3300 .had it done on monday was back home Thursday back to work Monday feels and looks amazing. She paid because insurance wouldnt have paid since she is only 5'2 179....its been 4 months and she is 138..looks wonderful 15 pounds ftom goal...now she is losing about 1pound a week

Share this post


Link to post
Share on other sites

Are you having issues? That's ludicrous to not weigh enough if you are having issues. I would appeal

Share this post


Link to post
Share on other sites

I heard several of the people actually put half pound weights in a couple of the pockets to give them additional weight

I had my lap band removed December 3, lived with it for four years because I lost my insurance . I was allergic to the band I spend a lot of time throwing up, my surgery date should be in March for the sleeve. I am at month five for my six-month diet I've lost 26 pounds....

Edited by Ann Fielder

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Bashbee91

      Hey guys new to the process looking forward to this new life. 
      · 0 replies
      1. This update has no replies.
    • Bugg

      Hi everyone! I’m brand new here. I just went through all my pre-op requirements per my insurance company and now everything has been submitted and I’m just waiting for final approval and my surgery date. I’ve been doing research, watching YouTube videos, TikTok’s, ect.. trying to prepare my mind and what to expect so I’ll be ready for the surgery. I was so sure and so set and so ready and excited. However, now that I’ve done everything & it’s almost here, I am sooooooo scared! I know why I want it bc I’ve tried everything and I just don’t feel like I can lose weight by myself. I’m tired of being overweight my entire life. I’m miserable, but I keep psyching myself out afraid of GERD bc I know how that can be and I don’t want to have to get a bypass after already gaining the courage to even get VSG. I’m scared of complications like I’mgoing to regret doing it and be depressed that I didn’t just be more disciplined and try again to lose the weight on my own even sitting here typing this knowing in my mind i just can’t and don’t possess the discipline. I’m also afraid I won’t be able to handle the restrictions of the sleeve. What do I eat? I don’t know how to eat healthy really and don’t enjoy healthy food. I don’t know how to do this! I feel so defeated!Someone tell me they felt anything similar to this or am I not ready? I thought I was. I am so tired of being sick and tired and so tired of myself and so tired of being stuck and stuck in this body and somebody different on the outside from what I feel inside. I just want to ball up and cry.
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      over 20 lbs down since4 the pre surgery diet and surgery on the 14th
      · 1 reply
      1. Selina333

        Yay!! Congrats. I know how good that feels. 🤩

    • Jenopolis

      Had a sleeve in 2017, lost over 100 pounds. Had a DS surgery this year (2025) for more sustainable weight loss. 🤞
      · 0 replies
      1. This update has no replies.
    • buildabetteranna

      The 14th was my day. I am home and recovery is going pretty smooth. They even let me walk out of the hospital. Picture of me in recovery curtesy of my boyfriend lol. 

      · 3 replies
      1. DaisyChainOz

        Glad it went well!! Wishing you a speedy recovery and wonderful success!! 🤗

      2. buildabetteranna

        Thank you ❤️

      3. Selina333

        Neat you have a pic of this day! I was sooo happy to get my surgery. It was well worth it! And I'm not even near my goal. I had surgery Dec. 2!

  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×